2020-11-13T11:12:45-06:00 2019-12-31 135565207 KPMG LLP 1212 NORTH 96TH STREET SUITE 300 OMAHA NE 68114 990 2019-01-01 420680355 JENNIE EDMUNDSON MEMORIAL HOSPITAL JENN 4023544840 933 EAST PIERCE STREET COUNCIL BLUFFS IA 51503 JEFFREY E FRANCIS VICE PRES FINANCE, CFO 4023544000 2020-11-13 1 DONALD NEAL JR P00798244 4023481450 2019 2022-09-23 18:48:47Z STEVEN BAUMERT 933 EAST PIERCE STREET COUNCIL BLUFFS IA 51503 135620949 0 X WWW.BESTCARE.ORG X 1894 IA TO PROVIDE AND MAINTAIN HOSPITAL AND AMBULATORY FACILITIES FOR THE CARE OF PATIENTS. 12 11 897 339 587100 161501 409879 1136547 108863143 111995170 3055857 7894568 1126279 949353 113455158 121975638 3749809 4405415 0 0 48890717 52303856 0 0 0 54138032 56801926 106778558 113511197 6676600 8464441 123635706 141736527 33834549 41671522 89801157 100065005 X THE MISSION OF JENNIE EDMUNDSON MEMORIAL HOSPITAL IS TO IMPROVE THE QUALITY OF LIFE BY CARING FOR THE BODY AND MIND. JENNIE EDMUNDSON SUPPORTS ITS MISSION OF CARING FOR PEOPLE THROUGH THE PROVISION OF INPATIENT AND OUTPATIENT HOSPITAL SERVICES ON ITS MAIN CAMPUS AT 933 EAST PIERCE STREET, COUNCIL BLUFFS, IOWA AND AT VARIOUS SATELLITE LOCATIONS THROUGHOUT SOUTHWEST IOWA. 0 0 6170624 471390 11236558 THE METHODIST JENNIE EDMUNDSON CARDIAC CENTER IS A LEADER IN THE TREATMENT OF COMPLEX HEART CONDITIONS OFFERING THE HIGHEST LEVEL OF CARE AND CARDIAC EXPERTS WHO USE ADVANCED DIAGNOSTIC AND THERAPEUTIC TECHNOLOGIES. OUR CARDIAC TEAM WORKS TO ENSURE PATIENTS HAVE THE HIGHEST QUALITY CARE - FROM DIAGNOSIS AND TREATMENT THROUGH RECOVERY AND REHABILITATION.SERVICES INCLUDE A CARDIAC CATHETERIZATION LAB, CHEST PAIN CENTER, HEART FAILURE PROGRAM, CARDIAC REHABILITATION SERVICES AND INPATIENT CARE PROVIDED BY A TEAM SPECIALIZED IN CARDIAC CARE. THE CHEST PAIN CENTER WAS MOST RECENTLY RE-ACCREDITED IN 2018 BY THE JOINT COMMISSION. MJE HAS BEEN ACCREDITED SINCE 2014.ALSO IN 2019, METHODIST JENNIE EDMUNDSON HOSPITAL WAS RECOGNIZED BY THE AMERICAN HEART ASSOCIATION AS THE RECIPIENT OF ITS MISSION: LIFELINE NSTEMI GOLD QUALITY ACHIEVEMENT AWARD AND MISSION: LIFELINE STEMI RECEIVING CENTER QUALITY ACHIEVEMENT GOLD AWARD FOR IMPLEMENTING SPECIFIC QUALITY IMPROVEMENT MEASURES OUTLINED BY THE AMERICAN HEART ASSOCIATION FOR THE TREATMENT OF PATIENTS WHO SUFFER HEART ATTACKS. 6199343 341930 8153844 METHODIST JENNIE EDMUNDSON CANCER CENTER IS THE ONLY CANCER CENTER IN WESTERN IOWA ACCREDITED BY THE AMERICAN COLLEGE OF SURGEONS, COMMISSION ON CANCER. THE PROGRAM HAS BEEN RECEIVING APPROVAL FROM THE COMMISSION ON CANCER (COC) SINCE 1996. COC APPROVAL MEANS THAT OUR PROGRAM MEETS PROGRAM STANDARDS, PROVIDES SUPPORT AND EDUCATION, AND DELIVERS QUALITY CARE TO ITS PATIENTS.ALL NEWLY DIAGNOSED CANCER PATIENTS' CASES ARE PRESENTED AT A WEEKLY CANCER CONFERENCE FOR IN-DEPTH REVIEW BY SURGEONS, RADIOLOGISTS, PATHOLOGISTS, MEDICAL AND RADIATION ONCOLOGISTS AND OTHER SPECIALIZED CARE PROVIDERS. METHODIST JENNIE EDMUNDSON HOSPITAL USES THE NEWEST EQUIPMENT AND TECHNOLOGY TO HELP FIGHT CANCER. 16692040 777059 18523326 THE SURGICAL TEAM AT METHODIST JENNIE EDMUNDSON HOSPITAL IS A HIGHLY TRAINED GROUP OF PHYSICIANS, NURSES AND OTHER HEALTH CARE PROFESSIONALS WHO WILL WORK CLOSELY WITH PATIENTS AND THEIR FAMILIES TO PLAN THEIR CARE AND ACHIEVE THE BEST OUTCOMES.SURGICAL SPECIALTIES FOR CHILDREN, ADOLESCENTS AND ADULTS INCLUDE THE FOLLOWING: DENTAL, GENERAL, GYNECOLOGY, HEART SURGERY, NEUROSURGERY, ORTHOPEDICS, PAIN MANAGEMENT, PEDIATRIC SURGERY, PLASTIC/RECONSTRUCTIVE, PERIPHERAL VASCULAR, RESPIRATORY/PULMONARY, SURGICAL ONCOLOGY, THORACIC, UROGYNECOLOGY AND UROLOGY. 69109943 2815036 74829169 JENNIE EDMUNDSON HOSPITAL IS THE OLDEST ENTITY IN THE NEBRASKA HEALTH SYSTEM FAMILY. IT IS A 230-BED REGIONAL HEALTH CARE CENTER SERVING SOUTHWESTERN IOWA. IT IS THE ONLY HOSPITAL IN THE REGION THAT OFFERS NATIONALLY ACCREDITED CANCER AND BREAST CANCER PROGRAMS.IN ADDITION TO BIRTH SERVICES, OTHER HEALTH CARE OFFERINGS INCLUDE DIABETES, EMERGENCY SERVICES, HEALTH AND LUNG WELLNESS, IMAGING, LUNG/PULMONARY, NEUROLOGY, NUTRITION COUNSELING, ORTHOPEDICS, PAIN MANAGEMENT, PATHOLOGY, PHYSICAL/OCCUPATION AND SPEECH THERAPY, SEXUAL ASSAULT/DOMESTIC VIOLENCE SERVICES, SLEEP, SPORTS MEDICINE URGENT CARE AND WOUND CARE. 69109943 2815036 74829169 98171950 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 X 61 0 1 897 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 12 11 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X JEFFREY E FRANCIS 4023544840 825 S 169TH STREET OMAHA NE 68118 JEFFREY FRANCIS CFO 6.00 34.00 X 0 547699 120992 HEATHER HERGOTT MD EMERGENCY ROOM PHYSICIAN 40.00 0.00 X 416732 0 20961 WILLIAM SHIFFERMILLER MD DIRECTOR 1.00 39.00 X 0 416348 82657 STEVEN BAUMERT PRESIDENT 35.00 5.00 X 0 389137 97379 PATRICK COSTELLO MD EMERGENCY ROOM PHYSICIAN 40.00 0.00 X 374314 0 48595 EVAN NEESEN MD PHYSICIAN 40.00 0.00 X 361868 0 40204 PAUL MILERIS MD PHYSICIAN 40.00 0.00 X 353332 0 51803 THOMAS CHEATLE MD PHYSICIAN 40.00 0.00 X 347186 0 49771 PEGGY HELGET EXEC. PATIENT SVCS 40.00 0.00 X 0 197629 38484 DAN KINNEY PHD CHAIRMAN 1.00 0.00 X X 0 0 0 EMMA CHANCE VICE CHAIRMAN 1.00 0.00 X X 0 0 0 THOMAS D WHITSON TREASURER 1.00 0.00 X X 0 0 0 JOHN NELSON SECRETARY 1.00 0.00 X X 0 0 0 DEB BASS DIRECTOR 1.00 0.00 X 0 0 0 JASON JAMES DIRECTOR 1.00 0.00 X 0 0 0 SPENCER C STEVENS DIRECTOR 1.00 0.00 X 0 0 0 LAWRENCE F UEBNER DIRECTOR 1.00 0.00 X 0 0 0 RICK CROWL JR DIRECTOR 1.00 0.00 X 0 0 0 MICHAEL ZLOMKE MD DIRECTOR 1.00 0.00 X 0 0 0 KAREN COLLINS DIRECTOR 1.00 0.00 X 0 0 0 1853432 1550813 550846 46 0 1 0 PATHLAB LTD 933 EAST PIERCE STREET COUNCIL BLUFFS IA 51503 MEDICAL SERVICES 6914417 HOLLAND BASHAM ARCHITECTS 119 S 49TH AVE OMAHA NE 68132 ARCHITECTURAL SERVICES 1334530 HORIZON HEALTH MANAGEMENT P O BOX 840839 DALLAS TX 75284 MEDICAL SERVICES 671977 ACCELECARE WOUND CENTERS 933 EAST PIERCE STREET COUNCIL BLUFFS IA 51503 MEDICAL SERVICES 412041 JE DUNN CONSTRUCTION CO 17110 MARCY SUITE LL01 OMAHA NE 68118 CONSTRUCTION SERVICES 374531 11 1136547 1136547 NET PATIENT SVC REV. 621990 110625284 110625284 OTHER PATIENT REVENUE 621990 1369886 1369886 111995170 7546514 7546514 1842741 2309077 -466336 -466336 -466336 11366894 196883 11195007 20716 171887 176167 348054 348054 201373 120511 80862 80862 CAFETERIA 722210 747727 747727 LABORATORY 621500 587100 587100 1334827 121975638 112742897 587100 7509094 60434 60434 4344981 4344981 39775059 39775059 2875491 2875491 6861083 6861083 2792223 2792223 62353 62353 18149 18149 128763 128763 10766089 10766089 158755 158755 1183890 1183890 30652 30652 4667358 4667358 51359 51359 23809 23809 4383810 4383810 573913 431931 141982 MEDICAL SUPPLIES 17827517 17827517 ALLOCATIONS 14988000 14988000 MEDICAID PROVIDER TAX 878434 878434 DUES, LICENSES AND SUBS 225334 225334 833741 833741 113511197 98171950 15339247 0 6961121 3254224 14473792 17157948 484393 886059 1489851 1676967 607024 629138 151449707 108335564 36144274 43114143 50199248 55368925 222744 232102 13053259 19417021 123635706 141736527 15011063 20717854 18823486 20953668 33834549 41671522 X 89701157 99965005 100000 100000 89801157 100065005 123635706 141736527 X 8464441 1799407 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 18149 0 0 0 18149 0 PART II-B, LINE 1: A PORTION OF THE ANNUAL DUES PAID TO THE AMERICAN HOSPITAL AND IOWA HOSPITAL ASSOCIATIONS IS ATTRIBUTABLE TO LOBBYING ACTIVITIES. 105814 105814 207314 -101500 105814 206865 13290 12841 207314 203643 9659 6437 206865 212488 -391 8454 203643 0.94510 0.05490 0 1 1 3277081 3277081 80996236 58025478 22970758 67176390 50310086 16866304 43114143 CONSTRUCTION IN PROGRESS 19248883 RIGHT OF USE ASSETS 168138 19417021 MINIMUM PENSION LIABILITY 20097911 COND. ASSET RETIREMENT OBLIGATION 770549 LONG TERM OPERATING LEASE LIABILITY 85208 20953668 X PART V, LINE 4: PERMANENTLY RESTRICTED NET ASSETS INCLUDE ENDOWMENT FUNDS WHICH ARE INTENDED TO BE HELD IN PERPETUITY. THE INCOME ON SUCH FUNDS IS EXPENDABLE FOR THE BENEFIT OF JENNIE EDMUNDSON MEMORIAL HOSPITAL. PART X, LINE 2: JENNIE EDMUNDSON MEMORIAL HOSPITAL RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED. CHANGES IN RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. IN 2019 AND 2018 MANAGEMENT DETERMINED THERE ARE NO INCOME TAX POSITIONS REQUIRING RECOGNITION IN THE FINANCIAL STATEMENTS. NO CHANGES WERE MADE TO THE FINANCIAL STATEMENTS DUE TO FIN 48. 1 1 X 1 X 1 X 1 1 1 0 1 1 3216492 18961 3197531 0.02820 18768060 16966204 1801856 0.01590 21984552 16985165 4999387 0.04410 387183 387183 0.00340 2001207 2001207 0.01760 717957 717957 0.00630 537769 537769 0.00470 3644116 3644116 0.03200 25628668 16985165 8643503 0.07610 16927 16927 0.00010 1012 1012 0.00000 297 297 0.00000 134672 134672 0.00120 152908 152908 0.00130 1 3862824 33816152 35259936 -1443784 X 1 1 1 1 JENNIE EDMUNDSON MEMORIAL HOSPITAL 933 EAST PIERCE STREET COUNCIL BLUFFS IA 51503 WWW.BESTCARE.ORG 780039H X X X X JENNIE EDMUNDSON MEMORIAL HOSPITAL 1 0 0 1 X X X X X X X X X 18 1 1 1 1 X WWW.BESTCARE.ORG/ABOUT/COMMUNITY-BENEFITS/OUR-PLAN/ X 1 18 1 WWW.BESTCARE.ORG/ABOUT/COMMUNITY-BENEFITS/OUR-PLAN/ 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X 1 X WWW.BESTCARE.ORG/TOOLS/FINANCIAL-ASSISTANCE/ X WWW.BESTCARE.ORG/TOOLS/FINANCIAL-ASSISTANCE/ X WWW.BESTCARE.ORG/TOOLS/FINANCIAL-ASSISTANCE/ X X X X X X X 1 X 0 X X X X 1 X 0 0 JENNIE EDMUNDSON MEMORIAL HOSPITAL PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS SPONSORED BY A COALITION OF LOCAL HEALTH SYSTEMS AND LOCAL HEALTH DEPARTMENTS. THE CHNA WAS CONDUCTED BY PROFESSIONAL RESEARCH CONSULTANTS INC. (PRC), A NATIONALLY-RECOGNIZED HEALTHCARE CONSULTING FIRM WITH EXTENSIVE EXPERIENCE CONDUCTING COMMUNITY HEALTH NEEDS ASSESSMENTS.THE CHNA INCORPORATED DATA FROM BOTH QUANTITATIVE AND QUALITATIVE SOURCES. QUANTITATIVE DATA INCLUDED PRIMARY DATA REPRESENTATION FROM TELEPHONE INTERVIEWS WHICH INCORPORATED BOTH LANDLINE AND CELL PHONE INTERVIEWS. THIS TELEPHONE SURVEY CONSISTED OF AN INITIAL STRATIFIED RANDOM SAMPLE OF INDIVIDUALS AGE 18 AND OLDER IN THE METRO AREA. OVERSAMPLING WAS THEN UTILIZED, WHICH RESULTED IN CONTACT WITH 2,527 METRO AREA RESIDENTS. IN ADDITION 163 COMMUNITY STAKEHOLDERS TOOK PART IN AN ONLINE KEY INFORMANT SURVEY, INCLUDING PHYSICIANS, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, BUSINESS LEADERS AND OTHER COMMUNITY LEADERS. JENNIE EDMUNDSON MEMORIAL HOSPITAL PART V, SECTION B, LINE 6A: THE CHNA WAS A COLLABORATIVE EFFORT OF THREE OMAHA HEALTH SYSTEMS - NEBRASKA METHODIST HEALTH SYSTEM, CHI HEALTH SYSTEM AND NEBRASKA MEDICINE AS WELL AS DOUGLAS COUNTY HEALTH DEPARTMENT, WITH SUPPORT FROM LOCAL HEALTH DEPARTMENTS FROM SARPY/CASS COUNTIES, NEBRASKA AND POTTAWATTAMIE COUNTY, IOWA. JENNIE EDMUNDSON MEMORIAL HOSPITAL PART V, SECTION B, LINE 6B: IN ADDITION TO THE THREE OMAHA HEALTH SYSTEMS, AND LOCAL HEALTH DEPARTMENTS IDENTIFIED ABOVE, THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) INCLUDED SUPPORT FROM CHARLES DREW HEALTH CENTER, INC., LIVE WELL OMAHA, OMAHA COMMUNITY FOUNDATION, ONE WORLD COMMUNITY HEALTH CENTERS INC., AND UNITED WAY OF THE MIDLANDS. JENNIE EDMUNDSON MEMORIAL HOSPITAL PART V, SECTION B, LINE 11: 2018 IMPLEMENTATION STRATEGY UPDATE:OVERVIEWTHE METHODIST JENNIE EDMUNDSON HOSPITAL (MJE) IS COMMITTED TO CARING FOR ITS COMMUNITY, LIVING THE MISSION OF IMPROVING THE LIVES OF OUR COMMUNITIES BY THE WAY WE CARE, EDUCATE AND INNOVATE. ALL LEADERSHIP SUPPORT THE IMPORTANCE OF WORKING IN THE COMMUNITY WITH OVER 260 PARTNERS IN THE LAST DECADE TO ADDRESS THE IDENTIFIED NEEDS THROUGH THE REGION'S COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). MANAGEMENT AND BOARD MEMBERS HAVE APPROVED THE 2018 - 2020 IMPLEMENTATION STRATEGY PLAN TO STRATEGICALLY ADDRESS THE NEEDS IDENTIFIED IN THE CHNA, IN ACCORDANCE WITH OUR TALENTS, RESOURCES AND AREAS OF EXPERTISE. EACH COMMUNITY BENEFIT PROGRAM INCLUDES AT LEAST ONE OF THE FOLLOWING: ADDRESSING ACCESS TO HEALTH CARE SERVICES ENHANCING THE HEALTH OF THE COMMUNITY ADVANCING MEDICAL OR HEALTH CARE KNOWLEDGE RELIEVING OR REDUCING THE BURDEN OF THE GOVERNMENTAS MENTIONED THROUGHOUT THIS REPORT, MJE (AS AN AFFILIATE OF NEBRASKA METHODIST HEALTH SYSTEM) HAS WORKED WITH OVER 260 ORGANIZATIONS IN THE LAST DECADE THROUGH PREVENTION ACTIVITIES, HEALTH PROMOTION, SOCIAL SERVICES, PASTORAL CARE, NUMEROUS VOLUNTEER EFFORTS, AND PROFESSIONAL EDUCATION, AS WELL AS DIRECT AND INDIRECT CONTRIBUTIONS. LIKEWISE, MJE REMAINS A STRONG LEADER IN IMPROVING THE HEALTH OF OUR COMMUNITIES - A STATEMENT WE REMAIN HIGHLY PROUD TO MAKE. IN ORDER TO ADDRESS THE MANY IDENTIFIED NEEDS OF OUR COMMUNITIES, WE REMAIN COMMITTED TO THOSE ORGANIZATIONS WHO HAVE ADDITIONAL EXPERTISE IN AREAS WE FEEL WOULD SERVE AS A PRUDENT PARTNER. IN THE FOLLOWING PAGES, WE ADDRESS THE RESULTS OF SIGNIFICANT ACTIONS TAKEN TO ADDRESS OUR TOP PRIORITIES ACROSS OUR COMMUNITIES.ACCESS TO HEALTHCARE SERVICES THE METHODIST MOBILE MAMMOGRAPHY COACH CONTINUES TO TRAVEL ACROSS NEBRASKA AND SOUTHWESTERN IOWA SERVING LOCAL COMMUNITY CENTERS, BUSINESSES AND UNDERSERVED NEIGHBORHOODS. IN ITS FIRST YEAR OF OPERATION, THE METHODIST MOBILE MAMMOGRAPHY UNIT PROVIDED NEARLY 2,000 MAMMOGRAMS IN 2019 TO WOMEN ACROSS THE METROPOLITAN REGION, INCLUDING 401 WOMEN RECEIVING A MAMMOGRAM FOR THE VERY FIRST TIME.CANCER METHODIST JENNIE EDMUNDSON CONTINUES TO INCREASE ITS OFFERINGS OF A VARIETY OF CANCER SCREENINGS, INCLUDING FREE HEAD & NECK OUTREACH INITIATIVES, TO INCLUDE LOCATIONS ON-CAMPUS AND THROUGHOUT THE LOCAL COMMUNITY. THERE ARE A NUMBER OF OTHER FREE CANCER SCREENINGS THROUGHOUT THE COMMUNITY IN PARTNERSHIP WITH OTHER HEALTH AGENCIES AND ORGANIZATIONS, FOCUSING ON: BREAST, LUNG AND SKIN, AMONG OTHERS. THESE EVENTS ARE HELD IN TANDEM WITH METRO-WIDE EVENTS, SUCH AS THE BINATIONAL HEALTH WEEK.THROUGH EVERY OUTREACH EVENT, MJE PROVIDES FREE SCREENINGS, EDUCATION AND REFERRALS (IF DEEMED NECESSARY) TO WHOEVER THE INDIVIDUAL'S PRIMARY CARE PROVIDER IS, REGARDLESS OF ANY HEALTH SYSTEM AFFILIATION; WE ALSO REFER TO FEDERALLY-QUALIFIED HEALTH CENTERS WHEN APPLICABLE.HEART DISEASE & STROKE SIMILAR TO OTHER COMMUNITY BENEFITS ACTIVITIES, EVERY SCREENING OFFERED INCLUDES A NUMBER OF HEALTH EDUCATIONAL METHODS, AND HEART DISEASE AND STROKE ARE NO DIFFERENT. FREE BLOOD PRESSURES AND OTHER VITAL STATISTICS ARE TAKEN, AND ONE-ON-ONE CONSULTATION WITH A LICENSED STAFF MEMBER IS AVAILABLE AT NEARLY EVERY COMMUNITY EVENT. THESE CONSULTATIONS INCLUDE SPECIALIZED EDUCATION REGARDING HEALTHY LIFESTYLE CHOICES THAT CAN REDUCE HEART DISEASE AND CHANCES OF STROKE, INCLUDING BUT NOT LIMITED TO: HEALTHY EATING, FOOD PROPORTIONS, COOKING INSTRUCTIONS AND HOW TO MAKE LOW-COST MEALS FOR FAMILIES.MENTAL HEALTH & SUBSTANCE ABUSE METHODIST JENNIE EDMUNDSON PROVIDES PSYCHIATRIC TREATMENT FOR MORE THAN 1,400 MEMBERS IN THE SURROUNDING AREA PER YEAR, PROVIDING THE FOLLOWING SERVICES TO PATIENTS: -SHORT-TERM ACUTE INPATIENT PSYCHIATRIC TREATMENT FOR INDIVIDUALS 18 YEARS AND OLDER - CO-OCCURRING TREATMENT (DUAL DIAGNOSIS) FOR INDIVIDUALS DIAGNOSED WITH A PSYCHIATRIC DISORDER IN CONJUNCTION WITH A SUBSTANCE ABUSE/CHEMICAL DEPENDENCY DIAGNOSIS - GROUP AND RECREATIONAL THERAPY - 24-HOUR NURSING AND MEDICAL SUPPORT - INDIVIDUALIZED TREATMENT PLANNING - MEDICATION STABILIZATION AND MANAGEMENT - FAMILY EDUCATION AND SUPPORT - BASIC LIFE SKILL ENHANCEMENT - DISCHARGE AND AFTERCARE PLANNING - REFERRAL FOR FOLLOW-UP SERVICESCARING FOR OUR COMMUNITIESIN 2019, MJE CONTINUED ITS STRONG PARTNERSHIP WITH CONNECTIONS TO SUSTAIN THE CARING FOR OUR COMMUNITIES IN SOUTHWEST IOWA PROGRAM, WHICH ASSISTED 2,048 INDIVIDUALS PRESENTING TO THE HOSPITAL WITH URGENT AND EMERGENT NEEDS. THIS PROGRAM TRACKED SOCIAL DETERMINANT OF HEALTH DATA. THERE WERE 3,919 REFERRALS TO LOCAL, COMMUNITY-BASED ORGANIZATIONS AND PROGRAMS SUCH AS LEGAL AID, HEARTLAND FAMILY SERVICES (HFS), AND VARIOUS PHYSICIAN PRACTICES, AND HELPED 559 INDIVIDUALS TO OBTAIN HEALTH INSURANCE. THIS PROGRAM INCREASES MULTIPLE POINTS OF ACCESS FOR UNDER-RESOURCED INDIVIDUALS AND THEIR FAMILIES, AND IS THE MOST IMPORTANT INITIATIVE MJE HAS TO OFFER APPROPRIATE SERVICES IN A TIMELY MANNER.THROUGH CONNECTIONS AREA AGENCY ON AGING (CONNECTIONS), MJE ALSO FUNDS A COMMUNITY OUTREACH COACH, AND A BEHAVIORAL HEALTH COORDINATOR THROUGH HEARTLAND FAMILY SERVICES, WHOSE RESPONSIBILITIES INCLUDE: SCREENING, ASSESSING, REFERRING AND COORDINATING SERVICES FOR PATIENTS FACING COMPLEX MEDICAL ISSUES. THIS PARTNERSHIP ALLOWS FOR MANY HEALTH AND HUMAN SERVICES ORGANIZATIONS TO COLLABORATE ON A MORE EFFICIENT BASIS TO EFFECT TIMELY, APPROPRIATE REFERRALS AND CARE COORDINATION.FINANCIAL ASSISTANCEIN 2019, MJE WAS ABLE TO ASSIST OVER 4,800 INDIVIDUALS WITH FINANCIAL ASSISTANCE, THEREBY REDUCING OR ELIMINATING THE MEDICAL PAYMENT BURDEN ON FAMILIES, ALLOWING THEM TO AFFORD HOME OWNERSHIP, EDUCATIONAL EXPENSES, AND HEALTHIER LIFESTYLE AND FOOD CHOICES. OUR FINANCIAL ASSISTANCE PROGRAM IS OFFERED TO ALL PATIENTS UPON ADMISSION AND OUR PROVIDERS ARE KNOWLEDGEABLE REGARDING HOW THEIR PATIENTS CAN APPLY FOR THIS PROGRAM. EVALUATING OUR IMPACTIN ORDER TO BE THE BEST COMMUNITY STEWARDS AND HEALTHCARE PROFESSIONALS, MJE CONTINUALLY EVALUATES ALL PROGRAMS AND SERVICES REPORTED AS COMMUNITY BENEFITS IN ORDER TO ENSURE THAT BEST PRACTICES ARE USED TO IMPROVE HEALTH OUTCOMES. MJE USES A MULTI-DISCIPLINE APPROACH IN REVIEWING ALL PROGRAMS AND CONTINUES TO MOVE TOWARDS USING EVIDENCE-BASED MODELS. AS A HEALTH SYSTEM, METHODIST HAS CONTRIBUTED OVER HALF A BILLION DOLLARS IN COMMUNITY BENEFITS SINCE 2008, DEMONSTRATING THE LEVEL OF COMMITMENT THROUGH OUR MISSION STATEMENT, STRATEGIC PLAN AND COMMUNITY BENEFIT PROGRAMS. JENNIE EDMUNDSON MEMORIAL HOSPITAL PART V, SECTION B, LINE 13B: METHODIST JENNIE EDMUNDSON CHARGES MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE FOR PATIENTS OR GUARANTORS WITH FAMILY INCOME GREATER THAN 400% OF THE FEDERAL POVERTY LEVEL WHEN CIRCUMSTANCES INDICATE SEVERE FINANCIAL HARDSHIP. PATIENTS, OR THEIR GUARANTORS, MAY BE ELIGIBLE FOR MEDICAL HARDSHIP ASSISTANCE IF THEY HAVE INCURRED OUT-OF-POCKET OBLIGATIONS RESULTING FROM MEDICAL SERVICES THAT EXCEED 25% OF FAMILY INCOME AND SUFFICIENT FAMILY ASSETS ARE NOT AVAILABLE TO MEET THE OBLIGATION. JENNIE EDMUNDSON MEMORIAL HOSPITAL PART V, SECTION B, LINE 13H: METHODIST JENNIE EDMUNDSON UNDERSTANDS THAT NOT ALL PATIENTS ARE ABLE TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION OR COMPLY WITH REQUESTS FOR DOCUMENTATION. THERE MAY BE INSTANCES UNDER WHICH A PATIENT'S QUALIFICATION FOR FINANCIAL ASSISTANCE IS ESTABLISHED WITHOUT COMPLETING THE FORMAL FINANCIAL ASSISTANCE APPLICATION. OTHER INFORMATION MAY BE UTILIZED TO MAKE AN INFORMED DECISION ON FINANCIAL NEED SUCH AS: HOMELESS, DECEASED - NO KNOWN ESTATE, WIC PROGRAM ELIGIBILITY OR SNAP BENEFITS.ADDITIONALLY, METHODIST JENNIE EDMUNDSON UTILIZES A PRESUMPTIVE ELIGIBILITY ANALYTICS SOLUTION THAT EXAMINES HISTORICAL DATA COMBINED WITH HOUSEHOLD ECONOMIC INFORMATION. IT EVALUATES ACCOUNTS BASED ON THE FOLLOWING STANDARDS: AVAILABLE HOUSEHOLD INCOME, HOUSEHOLD SIZE, CAPACITY TO MAKE PAYMENT, AND OVER-EXTENSION COMPARED TO FEDERAL POVERTY GUIDELINES. THIS INFORMATION IS DERIVED FROM SOCIO-ECONOMIC DATA FROM NUMEROUS SOURCES, INCLUDING CENSUS DATA. USING THIS PRESUMPTIVE ELIGIBILITY APPROACH, A SCORE IS ASSIGNED AT THE INDIVIDUAL PATIENT LEVEL. THE SCORE ENABLES THE PATIENT FINANCIAL SERVICES TO MEET INTERNAL PROCESSING REQUIREMENTS WHILE PROVIDING A COMMUNITY BENEFIT THROUGH FORGIVING ACCOUNT BALANCES FOR THOSE IN NEED.THIS APPROACH ENABLES METHODIST JENNIE EDMUNDSON TO EVALUATE ACCOUNTS FOR FINANCIAL ASSISTANCE EQUALLY, REGARDLESS OF THE PATIENT'S ABILITY TO COMPLETE AN APPLICATION FOR ASSISTANCE.WHEN THE PRESUMPTIVE ELIGIBILITY SOLUTION IS THE BASIS FOR DETERMINING ELIGIBILITY, A FULL FREE CARE DISCOUNT WILL BE GRANTED FOR ELIGIBLE SERVICES FOR RETROSPECTIVE DATES OF SERVICE ONLY. THESE ACCOUNTS WILL NOT BE SENT TO COLLECTION AND WILL NOT BE INCLUDED IN BAD DEBT EXPENSE. JENNIE EDMUNDSON MEMORIAL HOSPITAL PART V, SECTION B, LINE 16J: THE FINANCIAL ASSISTANCE APPLICATION IS PROVIDED WITH INPATIENT ADMISSION PACKETS. GUIDANCE TO THE POLICY IS REFERRED TO IN PATIENT STATEMENTS. PART I, LINE 7: THE METHODS PRIMARILY USED ARE THE FINANCIAL INFORMATION FROM THE MEDICARE COST REPORT AND ACTUAL EXPENDITURES. PART I, LINE 7G: A SUBSIDIZED HEALTH BENEFIT IS CALCULATED FOR DEPARTMENTS AND SERVICES RECOGNIZING THESE AREAS OPERATE AT A NEGATIVE MARGIN. TRANSPORT SERVICES AND CLINICS IN UNDERSERVED AREAS, FOR EXAMPLE, ARE SERVICES THAT OPERATE AT NEGATIVE MARGINS. PART I, LN 7 COL(F): THE PERCENTAGE IS ARRIVED AT BY DIVIDING NET COMMUNITY BENEFIT EXPENSES IN COLUMN (E) BY THE AMOUNT ON FORM 990, PART IX, LINE 25, COLUMN (A). PART I, LINE 6A AND 6B: ANNUAL COMMUNITY BENEFIT REPORT:NEBRASKA METHODIST HEALTH SYSTEM PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT WHICH INCLUDES INFORMATION ON COMMUNITY BENEFITS ACTIVITIES FROM ALL AFFILIATES. IN ADDITION, A QUARTERLY PUBLICATION, "CHART" ADDRESSES ONGOING COMMUNITY BENEFIT ACTIVITIES. THE WEBSITE "WWW.BESTCARE.ORG/ABOUT/COMMUNITY-BENEFITS/OUR-PLAN" IS DEDICATED TO METHODIST JENNIE EDMUNDSON AND NEBRASKA METHODIST HEALTH SYSTEM AFFILIATES' COMMUNITY WORKS. IT PROVIDES INFORMATION ABOUT THE SUCCESSES IN IMPACTING THE COMMUNITY'S OVERALL HEALTH.PART VI, LINE 7:NO DIRECT REPORT IS PROVIDED TO THE STATE OF IOWA. HOWEVER, INFORMATION FROM THE HOSPITAL'S COMMUNITY BENEFIT DATA IS INCLUDED IN A REPORT COMPILED BY THE IOWA HOSPITAL ASSOCIATION.PART I, LINE 7:INFORMATION ON PROGRAMS CONSTITUTING COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFIT OPERATIONS, SUBSIDIZED HEALTH SERVICES AND IN-KIND DONATIONS IS COLLECTED THROUGHOUT THE YEAR USING THE COMMUNITY BENEFITS INVENTORY SOCIAL ACCOUNTABILITY SOFTWARE WHICH FOLLOWS CATHOLIC HEALTH ASSOCIATION (CHA) GUIDELINES FOR COMMUNITY BENEFIT REPORTING. AMOUNTS SHOWN AS COMMUNITY BENEFIT ARE AT COST LESS ANY REVENUE EXCLUSIVE OF ANY GRANTS. CASH AND IN-KIND DONATIONS THAT SUPPORT FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT ACTIVITIES ARE INCLUDED IN CONTRIBUTIONS.PART I, LINE 7E:METHODIST JENNIE EDMUNDSON AND OTHER ORGANIZATIONS IN THE COMMUNITY HAVE UNITED IN THE SHAKEN BABY TASK FORCE IN A COMMUNITY EFFORT TO PREVENT SHAKEN BABY SYNDROME. THE TASK FORCE, LED BY MEMBERS OF THE STAFF OF JENNIE EDMUNDSON HOSPITAL, DEVELOPED A COPYRIGHTED CURRICULUM, VIDEO AND SAFEBABY.ORG WEBSITE AND THE NATION'S ONLY 24-HOUR DEDICATED CRYING BABY HOTLINE. THE VIDEO "SHAKEN BABIES: SHATTERED LIVES" IS FREE ON REQUEST AND HAS BEEN SENT TO REQUESTERS IN THE UNITED STATES AND COUNTRIES OUTSIDE THE UNITED STATES. RECENTLY, THE TASK FORCE EXPANDED THEIR MISSION TO INCLUDE KEEPING BABIES SAFE FROM SUDDEN INFANT DEATH SYNDROME (SIDS), CO-SLEEPING, AND SECOND AND THIRD-HAND SMOKE EXPOSURE.METHODIST JENNIE EDMUNDSON'S COMMITMENT TO SOUTHWEST IOWA EXTENDS TO A WIDE VARIETY OF OTHER ANNUAL SCREENING PROGRAMS ON PROSTATE CANCER, COLORECTAL CANCER, BREAST CANCER AND CERVICAL CANCER. IN ADDITION, PHYSICIANS AND HOSPITAL STAFF PROVIDE EDUCATIONAL PROGRAMS TO ORGANIZATIONS AND AT COMMUNITY EVENTS. PART II, COMMUNITY BUILDING ACTIVITIES: AS A COMMUNITY LEADER, METHODIST JENNIE EDMUNDSON EMPLOYEES ARE ACTIVE IN COMMUNITY ORGANIZATIONS, HOLDING LEADERSHIP ROLES ON BOARDS OF DIRECTORS, COMMITTEE CHAIRMANSHIPS AND MEMBERSHIPS. JENNIE EDMUNDSON PARTICIPATES IN THE CHAMBER OF COMMERCE, THE AMERICAN HEART ASSOCIATION AND OTHER ORGANIZATIONS TO STRENGTHEN THE INFRASTRUCTURE OF THE COMMUNITY. PART III, LINE 4: THE NEBRASKA METHODIST HEALTH SYSTEM ADOPTED THE NEW REVENUE RECOGNITION STANDARD IN 2019. BAD DEBT EXPENSE IS NO LONGER DISCUSSED SEPARATELY. THE FOOTNOTE ADDRESSING REVENUE RECOGNITION IS ON THE ATTACHED AUDITED FINANCIAL STATEMENTS, PAGE 12.THE COST METHODOLOGY FOR THE BAD DEBT EXPENSE PRESENTED IN THE PART III, LINE 2, IS CONSISTENT WITH THAT OF THE 2019 FILED MEDICARE COST REPORT. PART III, LINE 8: SOURCE FOR MEDICARE REVENUE AND ALLOWABLE COSTS IS THE 2019 MEDICARE COST REPORT AS FILED. PART III, LINE 9B: COLLECTION PRACTICES FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE.METHODIST JENNIE EDMUNDSON HAS ADOPTED A PROCEDURE FOR THOSE SITUATIONS WHERE A PATIENT POTENTIALLY MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE BUT HAS NOT OR CANNOT COMPLETE THE APPLICATION. THIS PROCEDURE, REFERRED TO AS THE PRESUMPTIVE CHARITY PROCESS, IS FOLLOWED BY HOSPITAL PERSONNEL AS WELL AS THIRD-PARTY VENDORS ASSISTING WITH SELF-PAY COLLECTIONS.SOME OF THE INDIVIDUAL LIFE CIRCUMSTANCES THAT HAVE BEEN ESTABLISHED AS INDICATORS OF PRESUMPTIVE ELIGIBILITY INCLUDE:PARTICIPATION IN STATE-FUNDED PRESCRIPTION PROGRAMS; RECEIVING CARE FROM A HOMELESS PERSONS CLINIC; PARTICIPATION IN WOMEN, INFANTS AND CHILDREN (WIC) PROGRAMS; SNAP BENEFITS; ELIGIBILITY FOR SUBSIDIZED SCHOOL LUNCH PROGRAM; ELIGIBILITY FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS THAT ARE UNFUNDED (E.G. MEDICAID SPEND-DOWN); LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AS VALID ADDRESS.THE HOSPITAL STAFF, AS WELL AS VENDORS UTILIZED FOR SELF-PAY COLLECTIONS, HAVE BEEN TRAINED TO IDENTIFY INDICATORS OF PRESUMPTIVE ELIGIBILITY AND DOCUMENT SUCH AS SUPPORT FOR A FINANCIAL ASSISTANCE DETERMINATION.THE HOSPITAL BILLS ALL THIRD PARTY RESOURCES THAT MAY BE ABLE TO PROVIDE REIMBURSEMENT FOR CARE PROVIDED TO PATIENTS. THIS INCLUDES, BUT IS NOT LIMITED TO, COMMERCIAL INSURANCE, MEDICARE, MEDICAID, COUNTY GOVERNMENT AND OTHER GOVERNMENT PROGRAMS, AND ANY OTHER POTENTIAL SOURCE OF REIMBURSEMENT.EVERY EFFORT IS MADE TO IDENTIFY PATIENTS THAT MAY QUALIFY FOR FINANCIAL ASSISTANCE PRIOR TO OR DURING THE TIME OF SERVICE. THOSE PATIENTS ARE ENCOURAGED TO COMPLETE AN APPLICATION FOR FINANCIAL ASSISTANCE. PART VI, LINE 2: BROAD-BASED COMMUNITY HEALTH AND OUTREACH INTIATIVES INCLUDE TARGETED PROGRAMS THAT ALIGN WITH KEY HEALTH NEEDS IDENTIFIED BY THE MOST RECENT CHNA. PART VI, LINE 3: FINANCIAL ASSISTANCE APPLICATIONS ARE INCLUDED IN ALL INPATIENT ADMISSION PACKETS. METHODIST JENNIE EDMUNDSON CONTRACTS WITH AN ELIGIBILITY SERVICE TO ASSIST INDIVIDUALS IN DETERMINING ELIGIBILITY AND COMPLETING THE REQUIRED PAPERWORK TO PARTICIPATE IN MEDICAID OR GOVERNMENT MEANS-TESTED PROGRAMS. HOSPITAL FINANCIAL COUNSELORS AND ELIGIBILITY SERVICE PERSONNEL ARE CONVENIENTLY LOCATED AT THE HOSPITAL FOR PRIVATE CONSULTATION FOR BOTH INPATIENT AND OUTPATIENT COUNSELING. THE COUNSELORS ARE INCLUDED IN THE ADMISSION/DISCHARGE PROCESS TO ENSURE THAT THE PATIENT IS FULLY INFORMED ABOUT THE PROCESS AND TO HELP THE PATIENT DETERMINE WHAT ASSISTANCE MAY BE NEEDED AND WHAT IS AVAILABLE TO THEM. THE HOSPITAL CUSTOMER SERVICE UNIT IS ALSO TRAINED TO ASSIST PATIENTS WITH FINANCIAL NEED. PATIENTS WHO CONTACT THE UNIT EXPRESSING DIFFICULTY IN MEETING THEIR FINANCIAL OBLIGATION ARE PROVIDED WITH APPLICATIONS AND ARE ASSESSED FOR ELIGIBILITY FOR FINANCIAL ASSISTANCE.APPROPRIATE RESOURCES ARE USED TO PROVIDE EFFECTIVE COMMUNICATION WITH NON-ENGLISH SPEAKING PATIENTS INCLUDING CYRACOM LANGUAGE LINE SYSTEM THAT PROVIDES 24-HOUR ACCESS TO SEVERAL HUNDRED DIFFERENT LANGUAGE INTERPRETERS. OTHER RESOURCES INCLUDE HOPE MEDICAL OUTREACH AND ON-SITE STAFF OR CONTRACTED INTERPRETER SERVICES. THE HOSPITAL PROVIDES FOR INTERPRETATIVE SERVICES AT NO COST TO THE PATIENT.INFORMATION ON THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE TO THE PUBLIC ON THE BESTCARE.ORG WEBSITE IN BOTH ENGLISH AND SPANISH. ADDITIONALLY, PATIENT STATEMENTS INCLUDE A STATEMENT ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE INCLUDING CONTACT INFORMATION. PLAIN LANGUAGE SUMMARIES AND APPLICATIONS ARE AVAILABLE AT ALL REGISTRATION DESKS WITHIN THE HOSPITAL. PART VI, LINE 4: METHODIST JENNIE EDMUNDSON SERVES COUNCIL BLUFFS, IOWA AND SURROUNDING COMMUNITIES IN SOUTHWESTERN IOWA.METHODIST JENNIE EDMUNDSON'S PROGRAMS ALIGN CLOSELY WITH THE KEY HEALTH NEEDS IDENTIFIED IN THE MOST RECENT CHNA. PART VI, LINE 5: METHODIST JENNIE EDMUNDSON'S BOARD OF DIRECTORS IS COMPOSED OF COMMUNITY LEADERS WITH DIVERSE BACKGROUNDS AND PROVIDES OVERSIGHT OF ALL OPERATIONS. THE COMPOSITION INCLUDES A COMBINATION OF THOSE WITH LONGEVITY ON THE BOARD AND THOSE WHO ARE NEWER MEMBERS. PHYSICIAN INVOLVEMENT ON THE BOARD ENHANCES THE HOSPITAL'S ABILITY TO BE A LEADER IN MEDICAL SERVICES.MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL PRACTITIONERS WHO CONTINUOUSLY MEET THE QUALIFICATIONS, STANDARDS AND REQUIREMENTS TO PROMOTE A UNIFORM STANDARD OF QUALITY PATIENT CARE, TREATMENT AND SERVICES. PART VI, LINE 6: THE NEBRASKA METHODIST HEALTH SYSTEM INCLUDES JENNIE EDMUNDSON MEMORIAL HOSPITAL AND JENNIE EDMUNDSON MEMORIAL HOSPITAL FOUNDATION, NEBRASKA METHODIST HOSPITAL, METHODIST FREMONT HEALTH, NEBRASKA METHODIST HEALTH SYSTEM, PHYSICIANS CLINIC INC., NEBRASKA METHODIST COLLEGE OF NURSING AND NEBRASKA METHODIST HOSPITAL FOUNDATION. AS A GROUP, THESE ENTITIES ARE COMMITTED TO CARING FOR THE PEOPLE OF THE COMMUNITY BY PROVIDING OUTSTANDING HEALTH CARE, EDUCATIONAL OPPORTUNITIES AND SUPPORT SERVICES. TO FULFILL OUR MISSION OF CARING FOR PEOPLE, AFFILIATES HAVE DEVELOPED A VARIETY OF WAYS TO CONTRIBUTE CARE AND HEALTH-RELATED EDUCATION TO THE POOR, TO MINORITIES, AND TO OTHER UNDERSERVED GROUPS AS WELL AS TO THE BROADER COMMUNITY. AS INDIVIDUAL AFFILIATES, A UNIFIED HEALTH SYSTEM AND AN ACTIVE PARTNER WITH OTHER COMMUNITY AND GOVERNMENTAL AGENCIES, JENNIE EDMUNDSON MEMORIAL HOSPITAL IS COMMITTED TO IMPROVING THE HEALTH AND QUALITY OF LIFE OF THE RESIDENTS OF THIS COMMUNITY. 0 JENNIE EDMUNDSON MEMORIAL HOSPITAL FOUNDATION 933 EAST PIERCE ST COUNCIL BLUFFS IA 51503 421439454 501(C)(3) 51000 SUPPORT OF FOUNDATION PROGRAMS 1 FINANCIAL ASSISTANCE 4828 4344981 BOOK FINANCIAL ASSISTANCE TO PATIENTS PART I, LINE 2: JENNIE EDMUNDSON MEMORIAL HOSPITAL ONLY PROVIDES GRANTS TO IRC SECTION 501(C)(3) ORGANIZATIONS AND 501(C)(3) ACTIVITIES TO ENSURE THE FUNDS ARE USED FOR EXEMPT PURPOSES. 0 1 0 0 0 0 0 0 0 JEFFREY FRANCIS CFO 0 472294 0 0 0 75405 0 94788 0 26826 0 669313 0 73229 HEATHER HERGOTT MD EMERGENCY ROOM PHYSICIAN 398836 0 9400 0 8496 0 10669 0 11848 0 439249 0 0 0 WILLIAM SHIFFERMILLER MD DIRECTOR 0 364507 0 0 0 51841 0 62867 0 21942 0 501157 0 23829 STEVEN BAUMERT PRESIDENT 0 349230 0 0 0 39907 0 79521 0 18480 0 487138 0 0 PATRICK COSTELLO MD EMERGENCY ROOM PHYSICIAN 349484 0 14300 0 10530 0 25099 0 25052 0 424465 0 0 0 EVAN NEESEN MD PHYSICIAN 345588 0 5750 0 10530 0 11192 0 30568 0 403628 0 0 0 PAUL MILERIS MD PHYSICIAN 332037 0 10800 0 10495 0 44411 0 8948 0 406691 0 0 0 THOMAS CHEATLE MD PHYSICIAN 334886 0 12300 0 0 0 33989 0 17338 0 398513 0 0 0 PEGGY HELGET EXEC. PATIENT SVCS 0 167982 0 0 0 29647 0 31356 0 7690 0 236675 0 0 PART I, LINE 3 JENNIE EDMUNDSON MEMORIAL HOSPITAL IS AN AFFILIATED MEMBER OF THE NEBRASKA METHODIST HEALTH SYSTEM. POLICIES ARE CENTRALIZED AT NEBRASKA METHODIST HEALTH SYSTEM INC. METHODIST HEALTH SYSTEM, WITH WHICH JENNIE EDMUNDSON IS AFFILIATED, RETAINS AN INDEPENDENT CONSULTANT TO REVIEW ALL OFFICER COMPENSATION FOR EACH AFFILIATE. UNDER THIS PROCESS, MARKET DATA ON COMPENSATION IS GATHERED AND ANALYZED AND COMPENSATION RANGES ARE SET. THE INFORMATION IS THEN PROVIDED TO THE COMPENSATION COMMITTEE OF THE BOARD OF NEBRASKA METHODIST HEALTH SYSTEM INC., A NEBRASKA NON-PROFIT CORPORATION AND A VOTING MEMBER OF JENNIE EDMUNDSON MEMORIAL HOSPITAL. ALL OFFICER COMPENSATION IS REVIEWED, EVALUATED AND APPROVED BY THIS COMMITTEE. PART I, LINE 4B THE FOLLOWING INDIVIDUALS PARTICIPATED IN A NONQUALIFIED PLAN DURING 2019 AND RECEIVED CONTRIBUTIONS, PLAN ACCRUALS OR PLAN DISTRIBUTIONS IN THE FOLLOWING AMOUNTS: STEVEN BAUMERT $51,521 ACCRUAL JEFFREY FRANCIS $78,826 ACCRUAL, $73,229 PLAN DISTRIBUTION WILLIAM SHIFFERMILLER MD $34,867 ACCRUAL, $23,829 DISTRIBUTION PEGGY HELGET $16,632 ACCRUAL PATRICK COSTELLO $25,099 ACCRUAL HEATHER HERGOTT $10,669 ACCRUAL THOMAS CHEATLE $33,989 ACCRUAL PAUL MILERIS $44,411 ACCRUAL EVAN NEESEN $11,192 ACCRUAL FORM 990, PART V, LINE 2B THE PAYROLL SYSTEM FOR JENNIE EDMUNDSON MEMORIAL HOSPITAL IS BEING HANDLED BY A COMMON PAYMASTER, NEBRASKA METHODIST HEALTH SYSTEM INC. ALL W-2 FORMS ARE ISSUED UNDER THE TAX IDENTIFICATION NUMBER OF NEBRASKA METHODIST HEALTH SYSTEM. ALL REQUIRED FEDERAL EMPLOYMENT TAX RETURNS WERE FILED BY NEBRASKA METHODIST HEALTH SYSTEM. WAGES AND BENEFITS SHOWN IN THIS FORM 990 ARE ACTUAL EXPENSES ASSOCIATED WITH JENNIE EDMONDSON MEMORIAL HOSPITAL PERSONNEL. FORM 990, PART VI, SECTION A, LINE 6 UNDER THE ARTICLES OF INCORPORATION OF JENNIE EDMUNDSON MEMORIAL HOSPITAL, AS RESTATED ON APRIL 29, 1994, THE WOMEN'S CHRISTIAN ASSOCIATION OF IOWA, AN IOWA NON-PROFIT CORPORATION IS A SPONSORING MEMBER OF JENNIE EDMUNDSON MEMORIAL HOSPITAL. UNDER THE SAME ARTICLES OF INCORPORATION, NEBRASKA METHODIST HEALTH SYSTEM INC., A NEBRASKA NON-PROFIT CORPORATION, IS A CORPORATE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A UNDER THE ARTICLES OF INCORPORATION OF JENNIE EDMUNDSON MEMORIAL HOSPITAL, AS RESTATED ON APRIL 29, 1994, THE WOMEN'S CHRISTIAN ASSOCIATION OF COUNCIL BLUFFS, IOWA, AN IOWA NON-PROFIT CORPORATION, IS A SPONSORING MEMBER OF THE ORGANIZATION AND HAS THE RIGHT TO NOMINATE TWO (2) OF ITS MEMBERS TO THE HOSPITAL'S BOARD OF DIRECTORS. LIKEWISE, THE NEBRASKA METHODIST HEALTH SYSTEM INC. HAS THE RIGHT TO NOMINATE TO THE HOSPITAL'S BOARD OF DIRECTORS THE NUMBER OF DIRECTORS THAT IS ONE (1) LESS THAN A MAJORITY OF THE SEATS ON THE BOARD OF DIRECTORS. NEBRASKA METHODIST HEALTH SYSTEM ALSO HAS THE RIGHT TO APPROVE ALL OF THE DIRECTORS NOMINATED. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING THE FORM 990, A COPY IS PROVIDED TO THE AUDIT AND COMPLIANCE COMMITTEE OF NEBRASKA METHODIST HEALTH SYSTEM AND THE JENNIE EDMUNDSON MEMORIAL HOSPITAL BOARD OF DIRECTORS. THEY ARE GIVEN AN OPPORTUNITY TO ASK QUESTIONS OR REQUEST MORE INFORMATION. INFORMATION FOR THE FORM 990 IS GATHERED FROM APPROPRIATE RESPONSIBLE PARTIES THROUGHOUT THE ORGANIZATION, INCLUDING THE ORGANIZATION'S HUMAN RESOURCES, FINANCE, COMPLIANCE, AND COMMUNITY BENEFITS DEPARTMENTS; IS REVIEWED BY EXTERNAL TAX ADVISORS AND HAS A FINAL REVIEW BY THE CHIEF FINANCIAL OFFICER FOR NEBRASKA METHODIST HEALTH SYSTEM AND THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER. FORM 990, PART VI, SECTION B, LINE 12C AN ANNUAL QUESTIONNAIRE IS SENT TO ALL OFFICERS, DIRECTORS, COMMITTEE MEMBERS, MEDICAL DIRECTORS, AND KEY EMPLOYEES PURSUANT TO THE METHODIST HEALTH SYSTEM CONFLICTS OF INTEREST POLICY WHICH REQUIRES THE DISCLOSURE OF RELATIONSHIPS, NOT JUST FINANCIAL, THAT COULD GIVE RISE TO CONFLICTS WITH THE ORGANIZATION. A BOARD COMMITTEE MEETS ANNUALLY TO REVIEW ALL POTENTIAL CONFLICTS IDENTIFIED THROUGH THE SURVEYS. SHOULD A DECISION COME TO THE BOARD WITH AN IDENTIFIED CONFLICT, THE OFFICER, DIRECTOR OR KEY EMPLOYEE IS NOT PERMITTED TO VOTE OR USE PERSONAL INFLUENCE ON THE MATTER AND IS NOT COUNTED IN DETERMINING THE QUORUM FOR A MEETING AT WHICH THE MATTER IS DISCUSSED. A POTENTIAL CONFLICT OF INTEREST ONCE IDENTIFIED MUST BE EVALUATED ON A CASE BY CASE BASIS. IN ORDER TO APPROVE THE TRANSACTION WHICH INVOLVES A DIRECT CONFLICT OF INTEREST, THE BOARD MUST FIRST FIND, BY MAJORITY VOTE OF DIRECTORS FOR WHOM NO CONFLICT EXISTS, AT A MEETING AT WHICH A QUORUM IS PRESENT, THAT THE ARRANGEMENT OR TRANSACTION IS IN THE BEST INTERESTS OF JENNIE EDMUNDSON MEMORIAL HOSPITAL AND/OR ITS HEALTH SYSTEM AFFILIATES, IS FAIR AND REASONABLE AND, AFTER INVESTIGATION, THE DIRECTORS HAVE DETERMINED THAT A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT CANNOT BE OBTAINED WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES. FORM 990, PART VI, SECTION B, LINE 15 JENNIE EDMUNDSON MEMORIAL HOSPITAL IS AN AFFILIATED MEMBER OF THE NEBRASKA METHODIST HEALTH SYSTEM. POLICIES ARE CENTRALIZED AT NEBRASKA METHODIST HEALTH SYSTEM INC. METHODIST HEALTH SYSTEM, WITH WHICH JENNIE EDMUNDSON IS AFFILIATED, RETAINS AN INDEPENDENT CONSULTANT TO REVIEW ALL OFFICER COMPENSATION FOR EACH AFFILIATE. UNDER THIS PROCESS, MARKET DATA ON COMPENSATION IS GATHERED AND ANALYZED AND COMPENSATION RANGES ARE SET. THE INFORMATION IS THEN PROVIDED TO THE COMPENSATION COMMITTEE OF THE BOARD OF NEBRASKA METHODIST HEALTH SYSTEM INC., A NEBRASKA NON-PROFIT CORPORATION AND THE VOTING MEMBER OF JENNIE EDMUNDSON MEMORIAL HOSPITAL. ALL OFFICER COMPENSATION IS REVIEWED, EVALUATED AND APPROVED BY THIS COMMITTEE. PHYSICIAN COMPENSATION IS COMPARED TO NATIONAL COMPENSATION SURVEY DATA FROM THE MEDICAL GROUP MANAGEMENT ASSOCIATION (MGMA) AND THE AMERICAN MEDICAL GROUP ASSOCIATION (AMGA). THE POLICY ON "PHYSICIAN COMPENSATION" IS FOLLOWED WHEN CONTRACTING WITH PHYSICIANS TO ENSURE APPROPRIATE APPROVALS, INCLUDING APPROVAL BY THE BOARD OF DIRECTORS, ARE OBTAINED WHEN WARRANTED. OPINIONS OF FAIR MARKET VALUE REGARDING A PARTICULAR COMPENSATION ARRANGEMENT OR TRANSACTION MAY ALSO BE OBTAINED FROM REPUTABLE, INDEPENDENT VALUATION CONSULTANTS. FORM 990, PART VI, SECTION C, LINE 18 THE FORM 1023 WAS FILED PRIOR TO 7/15/87 AND NEED NOT BE MADE PUBLICLY AVAILABLE. A COPY OF THE IRS LETTER 947 WILL BE PROVIDED UPON WRITTEN REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE THESE DOCUMENTS SEPARATELY AVAILABLE TO THE PUBLIC. HOWEVER, ARTICLES OF INCORPORATION FOR THE ORGANIZATION ARE AVAILABLE THROUGH THE IOWA SECRETARY OF STATE'S WEBSITE. THE CONFLICT OF INTEREST POLICY IS DISTRIBUTED TO ALL MEMBERS OF THE BOARD OF DIRECTORS. FINANCIAL INFORMATION IS AVAILABLE TO THE PUBLIC THROUGH THE IRS FORM 990 AND FORM 990-T. THE ORGANIZATION ALSO CONTRIBUTES INFORMATION REGARDING THE COMMUNITY BENEFITS IT PROVIDES AS PART OF THE METHODIST HEALTH SYSTEM'S ANNUAL COMMUNITY BENEFIT REPORT. THIS REPORT IS AVAILABLE TO THE PUBLIC ON THE WEBSITE WWW.BESTCARE.ORG/ABOUT/COMMUNITY-BENEFITS/COMMUNITY-IMPACT. FORM 990, PART XI, LINE 9: CHANGE IN MINIMUM PENSION LIABILITY -1,695,026. EQUITY TRANSFERS FROM AFFILATES 3,494,433. 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